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Children with flat feet, also called pes planus, have a flattening of the arch during standing and walking.

Flat foot is normal in infants and young children. At this age, in the absence of any associated symptoms, treatment is highly debatable.

Flat foot usually naturally corrects itself as muscles strengthen and soft tissues stiffen. The height of the arch in the foot increases with age until about 9 years. The problem is when flat foot persists, spontaneously occurs in older children or later in life, or is associated with pain and disability.

Flat feet can be flexible or rigid, painful or painless and associated with a tightness of the calf muscles (Achilles tendon). The majority of flat feet are painless, but when pain is present it is usually during weight-bearing activities such as walking and running. The pain can be in the sole of the foot, the ankle, or non-specific pain all around the foot area.

What causes flat feet?

A complex and sophisticated interaction of bones, ligaments, muscles and nerves within and above the foot defines its anatomy and function. Anything that interrupts the integrity of these structures leading to a collapsed arch can cause symptomatic flat feet.

Examination of the foot begins with an examination of the entire child, because the flat foot may have an underlying cause.

Flat foot can also originate from unusual anatomy such as a tarsal coalition (bones joined together), ligament or muscle damage, restricted ankle movement, outward rotated lower legs, and knock knees (where the legs bow inwards at the knee). Obesity can result in collapse of the arches by the increased load on the foot. If knock knees also develop, the middle of the foot will tend to turn out (abduct). The foot will point outwards when walking, instead of straight ahead, which is inefficient and can cause early fatigue.

Footwear in early childhood has been thought to cause flat foot. It is likely that children who wear shoes, are not physically active and have flat feet will have decreased muscle activation in their feet and thus impaired foot function and weakness.

Some older children and adolescents develop flat feet in the absence of any disorder or associated factors.

Does flat foot need to be treated?

Flat feet require treatment only if clearly associated with pain or decreased function. Managing the underlying cause or disease is of highest priority; just treating the symptoms should be secondary.

If flat foot is observed in a child who is overweight and has knock knees, or in a child with excess joint flexibility and poor footwear, each of these factors could be contributing to the symptoms, and each should be addressed.

If a child’s quality of life is affected by how their feet look, feel or function, then the associated issues should be addressed.

There are many causes of leg pain right from muscle cramps and inflammation of tendons to arthritis, varicose veins and nerve damage. Leg pain due to muscle strain following an injury or wearing tight shoes for a long time can be prevented by following few simple tips:

Stretch the leg muscle: One of the most effective ways to prevent leg pain due to a sudden muscle twist or cramp is to stretch the muscle. This not only improves blood flow to the injured muscle but it also helps in reducing muscle tension thereby relieving muscle soreness.

Take a warm shower: If you suffer from leg pain, then take a warm shower to relax the muscles. If taking a bath is not feasible, then placing a heating pad on the affected areas can also help. A heat pack works best if the pain is due to a previous injury as it not only relaxes blood vessels but also improves blood circulation, alleviating leg pain.

Wear a proper fitting athletic shoe: Most people fail to choose the right fitting shoe, which is one of the common causes of leg and heel pain. To get the right fit, determine the shape of your foot using the ‘wet test’. For this, step out of the shower onto a surface that will show your footprint, like a brown paper bag. If you have a flat foot, you will see an impression of your whole foot on the paper. If you have a high arch, you will only see the ball and heel of your foot. When shopping, look for athletic shoes that match your particular foot pattern.

Choose the right sports shoe: Not many people are aware that different types of shoes are specially designed to meet your sports requirement. Did you know running long distances in court-style sneakers can contribute to shin splints? It is important to choose the shoes according to your sport or fitness routine.

Go slow if you are a beginner at the gym: One of the common mistakes that most people commit is to overexert on the first day of the gym, which not only exerts pressure on the knee but also causes muscle soreness and leg pain. The key to preventing leg pain and sticking to your workout routine is to build your fitness level slowly. You can start off with less strenuous workouts and then gradually increase the duration, intensity, and frequency of your exercise regimen.

To avoid in-store arguments, parents and children should discuss in advance the style and brand of shoes they want to look for.

Remember that a good fit is more important than the size of the footwear. A good fit allows for a 1/2” of space between the end of the toes and the end of shoe. Shop at retailers who provide a fit specialist for extra assistance.

Remember that not all shoes of the same size fit alike. While foot measurement is a starting point, how the shoes fit is more important.

Match the shape of the shoe to the shape of the foot.

Remember that while a low arch is normal in young children, in children older than age seven, the lower the arch the more important it is to have shoes with good support. Look for a firm heel counter and stiffness when trying to twist shoes lengthwise.

If a child wears orthotics, select shoes with removable foot beds and try the shoes on with the orthotics in place.

Remember that price is not necessarily commensurate with quality. If price is a consideration, last year’s models can offer all the features needed at a discounted price.

Check the fit on your child’s shoes on a regular basis as children’s feet grow at irregular rates.

For more information, or if you have any questions, contact The Podiatrist

The importance of our feet has been understood for centuries. Even the Greek philosopher Socrates is reputed to have said, “To him whose feet hurt, everything hurts.” So, what comprises foot care that promotes comfort at any age?

Wear shoes and socks that fit and are comfortable.

Be sure your toes are not cramped.

Change socks daily and if possible have two pairs of shoes in everyday use so that you can alternate the pairs daily.

Elastic laces are handy if your feet swell.

Shoes should be worn that cover, protect, provide stability for the foot and minimize the chance of falls.

Whatever your age – student or grandparent – foot care is important.

Remember to cut or file your nails straight across and never shorter than the end of your toe.

If you are older, and particularly if you are diabetic, it is helpful to get The Podiatrist to do your foot care.

It is best to wash feet daily and always test the water’s temperature beforehand. Pat, do not rub, your feet dry and remember to dry between and under the toes. If your feet are bothering you you’ll find that short soaks of even ten minutes are soothing.

Use a lanolin (ointment base) moisturizing cream for dry and cracked skin. If your feet perspire, dust lightly with talcum powder. Remember to remove excess cream of powder from between your toes to avoid skin problems. If you are diabetic it is wise to examine your feet daily.

Exercise each day if possible. Walking is always good but there are also special foot exercises that can be done like rolling your feet over a rolling pin several times daily or picking up a crumpled towel with your toes.

Despite reasonable care throughout life, however, the older foot is subject to problems. Heredity is a factor as are the stresses over the years and complications from systemic diseases. It has been estimated that at least 80 percent of people over 50 have at least one foot problem.

The most common are corns and calluses, ingrown toenails, bunions, hammertoes, strained arches, heel pain and arthritis including gout.

In many cases there can be improvements jus by switching shoes to the type with wider, box-type toes. Also. shoe size can actually change with added years.

Feet carry our body’s weight, help hold us erect, co-ordinate and maintain balance in walking. We need to give them tender, loving and skilled care.

The chances are, you will, at some point in your life, experience corns or calluses on your feet. Sometimes a little extra scraping with a pumice stone, or even a careful slicing with a razor blade or similar sharp implement, during a day at the spa may suffice. But are those individuals really knowledgeable about your feet and health and safety issues?

Seeing The Podiatrist to remove painful corns and calluses safely with sterile instruments and medical knowledge is crucial. Under no circumstances should you attempt to cut the corn or callus yourself. You could make it more painful, and it might become infected. You can, occasionally, use a pumice stone or foot file to rub down skin that is getting thick.

Typical symptoms include:

Thickening of the skin

A hardened, raised bump or pit in the skin

Pain with pressure over skin irritations

Corns and calluses are annoying and potentially painful skin thickenings that form in areas of excessive pressure. A callus is often a flattened area of thick skin, while a corn is a thick, localized area that usually has a circular shape.

People of all ages can be affected, but they are particularly common in those over age 65. Corns and calluses have been shown to affect 20 to 65 per cent of people in this age range.

Podiatrists can also measure and fit people with custom-made orthotic devices to redistribute the weight on their feet while they walk so that pressure from the foot bones don’t focus on their corns. Off-the-shelf cushioned insoles are one-size-fits-all and may not be as effective.

Calluses and corns can often be prevented by reducing or eliminating the circumstances that lead to increased pressure at specific points on the feet.

Discuss your options with The Podiatrist, the professional foot care experts.

If you or a family member is experiencing any unusual sensations or symptoms with your feet, perhaps it’s time to seek professional help and book a consultation for a thorough examination, diagnosis and possible treatment.

The largest tendon in the body, the Achilles tendon connects your calf muscle to your bone. When this important tendon experiences degeneration due to wear and tear over time, the condition is called Achilles tendinitis. The main symptom of Achilles tendinitis is pain along the back of the leg, near the heel.

Depending on which part of the Achilles tendon is wearing and tearing the most, a person may have one of two types of Achilles tendinitis. The first is called non-insertional Achilles tendinitis, and it affects the middle portion of the tendon. According to experts, this form of Achilles tendinitis tends to be seen more frequently in younger people who are fairly active.

The other form this condition can take is called insertional Achilles tendinitis, and it affects the area where the Achilles tendon attaches to the heel bone. Experts report that this type of Achilles tendinitis can happen at any time, even if a person is not very active. The damaged tendon can harden, or calcify, in either form of Achilles tendinitis. However, in cases of insertional Achilles tendinitis, bone spurts, or extra bone growth, may also occur.

Fortunately, there are several non-invasive methods for dealing with Achilles tendinitis. One such method is the use of foot orthotics, and a foot orthotic that can lift the heels is a popular design for the treatment of this condition. By positioning the foot in a way that raises the heel, foot orthotics can ease strain on the Achilles tendon. Also, lifting the heel can help prevent the sore Achilles tendon from rubbing against the back of the shoe and further increasing irritation.

When using foot orthotics to help deal with and alleviate Achilles tendinitis, your health care professional may also suggest devices that provide extra cushioning to the heel. Creating a softer place for your heel within your shoes, this type of foot orthotic also can help to relieve the pain associated with Achilles tendinitis.

Along with the use of appropriate foot orthotics, The Podiatrist may also recommend several other methods for dealing with this painful condition. Slowing down and possibly completing stopping the movements that may have caused the condition in the first place is a logical first step. You may also be advised to switch from high-impact to low-impact exercises, along with icing the tendon, taking anti-inflammatory medication and engaging in prescribed exercise and stretches

You may choose to begin running to improve your physique, lose weight, increase cardiovascular fitness, or socialize with friends. Whatever the reason, it’s a good idea to identify this goal when creating your exercise program. If you want to improve cardiovascular fitness, for instance, you should run at a quick pace to maximize your heart rate. If you’re running to lose weight or reduce body fat, it’s better to run at a slower rate for a longer period of time. Depending on your goal, your doctor or personal trainer may decide that a modest walking or jogging program is appropriate. Setting goals helps you follow a safe pace and keeps you from overexertion, which can result in injury.

Have a physical evaluation.
Certain health problems may hamper your running performance and increase your risk for injury. Specifically, osteoporosis, arthritis, and other degenerative joint diseases can increase your injury risk. If you have any significant health issues, you should discuss these with your doctor before you start to run.

Warm up before your run and stretch after you run.
Doing so can prevent some of the most common injuries. It’s most important to stretch muscles that move joints. These include the calf muscle, which moves the knee and ankle, and the hamstring, which moves the knee and hip. Walk or gently jog for five minutes; cool down at the same pace for another five minutes at the end of your run.
Wear the correct shoes.
Buying shoes at an athletic store, where a salesclerk can help you choose a shoe that fits your foot type, can help prevent injuries.

Common injuries

The following injuries are common among runners:

Achilles tendonitis.
This injury is marked by dull or sharp pain along the back of the Achilles tendon, calf tightness, and early morning stiffness. Stretching can help prevent this injury. To treat it, rest, and stretch until the pain is gone.

Plantar fasciitis.
This injury is an inflammation of the plantar fascia, a thick, fibrous band of tissue in the bottom of the foot. Proper stretching can help prevent such an injury. Anti-inflammatory medication, stretching, and ice compresses help relieve pain.

Shin splints.
This injury, also called medial tibial stress syndrome, is caused by overuse or poor conditioning and worsened by running on hard surfaces. This injury causes pain on the inside of the shinbone. Shin splints are treated by complete rest and stretching until the pain is gone. You can relieve symptoms by stretching and using ice and anti-inflammatories. Once your symptoms have eased, you should make changes in the distance you run and your speed.

Sports are a large part of growing up and there is a high risk of active kids injuring their feet. Because of this, it’s important for parents to know the warning signs and what to watch out for when it comes to their children’s foot health.

Common injuries and symptoms

The most common injuries they see include ankle sprains from lack of support, chronic heel pain from overuse and inflammation in the heel bone, tendonitis and stress fractures.

To prevent injuries such as these for your children, it’s important to follow the following recommendations:

1) Watch for warning signs – Pain and swelling are often the easiest clues to spot. If your child is cautious to bear weight on a certain area or showing you parts of their ankles or feet that are swollen, the best home remedies include rest, ice and elevation.

If they complain of numbness, tingling or can’t move their limb properly, there may be a serious injury and you should make an appointment with a podiatrist.

2) Purchase sport-specific shoes – One of the easiest ways to prevent foot injuries while playing sports is to make sure that your child has shoes that are made specifically for the sport that he or she is playing. Due to the different movements each sport requires, the support and structure of their respective shoes can make a huge difference in comfort, stability and performance.

Running, for example, should be done in shoes that have good shock absorption, control, flexibility and room for orthotics (if they are needed). Custom or semi-custom inserts are wonderful for runners and the heel pain that often comes with the sport.

3) Make sure each pair of shoes fit properly – The ultimate key to the best foot health in children is to make sure their shoes fit correctly. While many parents who have multiple children often make use of hand-me-downs, it’s important to make sure that the shoes you’re giving your younger child aren’t too small.

Allowing enough room for the width of one finger between the big toe and the shoe is the rule of thumb (no pun intended).

We know that when it comes to our kids, health and safety are top priorities. Contact The Podiatrist if you are concerned about your child’s feet.

I wish I had a dollar for every time I hear my clients say “weak ankles”. The ankles are built to support nearly 100% of the body’s load, and if you look at the role of the joint in any sport which involves being on your feet, you will see that it can take very high impacts. It is flexible, resilient and capable of generating some serious explosive movements. So why do I see so many ankle injuries?

Understanding how such a brilliantly designed joint can turn weak lies in studying its functional relationship and interaction with the body’s other weight–bearing joints—the hips, knees and shoulders. The human body is a structure with several load-bearing joints, all of which will function at their optimum only if they are engaged together as a single unit—much like a well-made chair. The sturdy chair will bear the weight of the guest sitting on it pretty efficiently for years, but if people keep tipping the chair back and forth on its rear and front legs alternately, the chair will start wobbling and may ultimately collapse altogether. In the same manner, the body’s load-bearing joints will lose the benefit of its combined strength if the load is not distributed evenly along the shoulders, hips, knees and ankles. If anyone has to compensate regularly for the other, then that joint will deteriorate.

The ankle is particularly vulnerable as it bears the maximum load of the human body. This explains the high number of ankle-pain sufferers. The solution, however, does not lie in artificial support systems like taping, or special high-top shoes, or even surgery—it lies in spotting the deviant joint, understanding its relationship with the muscles around it, and aligning it with the rest of the load-bearing joints.

Calf muscles and ankles

The most common cause of ankle pain is dysfunctional and unusually shortened or tight calf muscles. For a human body to achieve proper locomotion, it is extremely important that the feet are able to dorsiflex. Dorsiflexion is the technical term used to describe the motion when the toes and feet move inwards towards the shin bone. While walking or running, when the foot hits the ground on impact, the shin has to move towards the feet in order to create the proper “give” or soft cushioning. This is only possible if the calf muscle is flexible and functional. If the calf muscle is tight, then the ankle abducts (moves outwards from the shin), unusually increasing its workload at impact. Moving away at impact takes it out of line to bear the body’s weight evenly, so there is too much load now acting on the inside of the ankle. Simple stretches to restore length back to the calf muscles, like the ones we will outline, sometimes take away chronic pain in the ankles, and make the joint more stable.

The Achilles tendon

The Achilles tendon attaches the muscles of the calf to the heel of the foot, and is hurt more often than any other tendon. The Achilles tendon’s opposing tendons attach the two heads of the gastrocnemius muscle (part of the calf muscle) to the two sides of the femur bone which significantly also form a part of the knee joint. Any misalignment of the knee joint, then, disrupts the tension and interaction of the tendons. The Achilles tendon, instead of delivering a fluid, smooth contraction, starts “twanging” and crimping. The Achilles tendon is not built to snag or to move such loads without help from the lower leg, hip or knee.

Since most women are slaves to fashion, paying the price to look good is very costly and painful. Shoe designers design shoes to look good — not necessarily to feel good. So whether you are wearing the latest peep-toe shoe styles, such as peep-toe pumps, sling-back pumps, platforms, booties, wedge pumps, sling-back sandals or flip-flops to kick around in, being able to customize and make your shoes more comfortable is paramount. For those professional women who have to go to trade shows for their work or are in sales and have to stand on their feet for long periods of time on hard, non-forgiving floor surfaces, by the end of the day their feet are screaming. The ultimate goal is to wear footwear without having to bring a spare pair of flats in your bag to save your feet from making you a cripple.

Shoe shapes are different than foot shapes

Fashion footwear that does not fit properly can result in many irritating and painful foot problems, especially for those who are on their feet for long periods of time. A shoe that is worn strictly for fashion reflects how stylish one wants to look at any cost and comfort definitely gets lost in the translation.

There are specific parts of fashion shoes that commonly cause foot problems and are notorious for driving women to the podiatrist’s office for help. The parts in question are the toe box, arch and the heel counter of the shoe. A toe box that is too narrow or shallow can be a major irritant to a foot that has bunion and hammertoe deformities. The lack of adequate support in the arch in a fashion shoes leads to tired legs or feet legs. Women who have narrow heels are challenged trying to find fashion shoes that fit their feet properly.

The reason for all these shoe issues is because “feet come in different sizes and shapes and shoes only come in different sizes.”

Shoes can also cause the formation of corns on the top or in between the toes, the development thick calluses that form on the ball of the foot because of the height or slope of the shoe, and the formation of blisters because of slippage issues in the heel. Repetitive rubbing and friction is the root of the problem and when feet slide around in shoes, skin problems can occur on the tops, bottoms and the heels of feet. Once corns and calluses form, they get thick, becoming too painful and makes walking in shoes more difficult. Making a visit to The Podiatrist is a must to solve that problem.

Shoes can also cause low back pain, calf pain, arch cramps and muscle spasms because of the lack of arch support and the pitch of the shoe which can be very dramatic in some styles. Unfortunately, the arch of the foot was not designed to bend at such acute angles for long periods of time making walking or standing on hard floor surfaces very challenging. The muscles in the calf and arch of the foot eventually fatigue causing them to cry for help!

Customization of shoe wear and tips to treat the problems shoes can cause

It is easy to “walk happily ever after,” because there are many over-the-counter foot products that one can buy to customize those hot, stylish, evil shoes in your shoe wardrobe and make them more comfortable to wear. To prevent irritation on the tops of your toes, line the underneath surface of the toe box with moleskin and it will reduce the friction, rubbing and corn formation. Callus formation on the ball of the foot can be reduced by adding a thin inner sole which should provide a soft friction — free landing with every step. There are over-the-counter liquid medications that say they remove corns or calluses — however, buyer beware because they can do more harm than good. These medications have strong chemicals in them that can be very caustic to the skin.

Arch supports from The Podiatrist that can be placed in the arch of the shoe or sandal are also helpful to prevent foot slippage, take pressure off the ball of the foot and eliminate arch cramps and muscle spasms. They can also keep the foot more stable in a shoe by preventing the arch from collapsing.

Placing moleskin in the lining of the heel counter may also prevent blister formation. If the problem occurs because the shoe leather is not soft enough to conform to the foot, try going to a shoe repair shop and see if they can spray a solution on the leather to soften or stretch it.

Finding a pair of shoes in your closet that will last all day on your feet without making you miserable is often a daunting task. Using these helpful tips can now make your life much easier.